Title

Authors

Date of Completion

January 2006

Keywords

Psychology, Clinical|Sociology, Criminology and Penology

Degree

Ph.D.

Abstract

Use of coercion in mental health and substance abuse treatment is controversial. Little empirical evidence exists regarding the impact of coercion on outcomes, even less regarding, perceived coercion. Potential for coercion is high when there is criminal justice involvement. Participants (n=982) from a national sample of persons with co-occurring disorder who had been diverted from jail and into treatment were categorized as either perceived coercion or no perceived coercion on three different coercion types: loss of parental rights, threat of incarceration, and threat of psychiatric hospitalization. A series of hierarchical multiple regressions were conducted across' coercion types to examine relationships between a sense of coercion and several outcomes at three months: mental health symptoms, quality of life, recidivism, and substance abuse. Results indicate that, after controlling for demographic and personal characteristics and baseline scores, parental rights coercion was significantly related to QOL scores (ΔR2=.006, p≤.02), incarceration coercion and CSI scores were significantly related (ΔR2=.005, p≤.02) and perceived coercion regarding psychiatric hospitalization coercion was marginally related (p=.08) to CSI scores. All of these relationships were negative, such that being in the coercion group was associated with lower scores. The three coercion groups did not additionally explain variance to a significant degree on any of the remaining outcomes. It appears from these results that perception of incarceration and hospitalization coercion are related to better mental health symptoms and perceived parental rights coercion is associated with higher QOL ratings. Treatment and policy implications are discussed. ^